Individual
TANYA COLUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MS
Contact information
Practice address
1 PROMENADE ST, SUITE 201, BLUFFTON, SC 29910-7037
(202) 812-4242
Mailing address
52 SUGAR MAPLE ST, BLUFFTON, SC 29910-7678
(202) 812-4242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MAS 8971
SC
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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